A National Consultant Information Programme Data Analysis of Deep Venous Interventions in England

The aim of this study was to characterise contemporary deep venous interventions (DVIs) performed within the English National Health Service (NHS), describing procedural mix, patient heterogeneity, anatomic distribution, and short and midterm outcomes.

National data on DVIs performed between 1 June 2020 and 31 May 2023 were extracted from the National Consultant Information Programme. Percutaneous transluminal venous procedures (PTVs) and venous thrombolysis were identified using pre-defined procedural and diagnostic code hierarchies. All cases underwent structured patient level validation to ensure concordance between indication, treated venous anatomy, and procedural intent. The primary outcomes were ninety day and one year mortality. Secondary outcomes included procedural volume variation. Re-interventions were recorded descriptively.

In total, 2 339 DVIs were performed, of which 1 617 PTVs and 604 venous thrombolysis procedures were validated. Patient cohorts were heterogeneous, most commonly chronic kidney disease (CKD) (41.8%), chronic venous insufficiency (CVI) (16.0%), and venous compression syndromes (14.0%). Anatomic distribution differed markedly by indication: CKD procedures predominantly involved upper limb and central veins, whereas CVI and venous compression were overwhelmingly confined to the lower limbs and iliocaval system. Among 650 patients with primary lower limb venous disease (CVI, venous thrombosis, or venous compression), 76.3% underwent iliac or inferior vena cava interventions. Overall mortality varied substantially by indication, being highest in patients with malignant neoplasms and lowest in primary lower limb venous disease. Thrombolysis was most frequently performed for lower extremity venous thrombosis and was associated with low short and midterm mortality in this group.

This service level analysis of DVIs in England demonstrates distinct clinical populations with marked differences in anatomy, indication, and outcomes that vary substantially by indication and comorbidity. Mortality was lowest in elective primary lower limb venous disease and highest in patients with advanced systemic illness such as malignancy and renal disease. Future work should focus on indication specific venous registries and risk adjusted outcomes to aid benchmarking, service level organisation, and patient care.